This week I would like to address the issue of chronic diseases and chronic disease management. Health concerns are generally classified as either acute or chronic. Acute illnesses usually begin abruptly and last only for a short period of time. There is every expectation that a person with an acute illness will return to normal health.
A chronic disease on the other hand tends to develop slowly, last long periods of time, and often is never cured. In some cases, there is no cure. Long-term effects of chronic ailments are difficult to predict and while some conditions may only present episodic problems or symptoms that can be controlled with medication, others are degenerative with constantly changing medical challenges. Some examples of chronic diseases include diabetes, congestive heart failure, asthma, hypertension, chronic kidney disease, depression, arthritis, emphysema and multiple sclerosis.
There are a wide variety of chronic diseases, but there are many similar concerns for those who live with them. Some of the common concerns include:
- knowing how to recognize and respond to changes in a chronic disease
- dealing with problems and emergencies
- using medicines and treatments effectively
- finding and using community resources
- getting enough exercise
- coping with fatigue, pain and sleep problems
- maintaining good nutrition
- making decisions about when to seek medical help
- working with your doctor(s) and other care providers
- talking about your illness with family and friends
- managing work, family and social responsibilities
With all this information in mind, chronic disease management is a systematic approach to improving health care for people with a chronic ailment. Health care can be delivered more effectively and efficiently if patients with chronic diseases take an active role in their own care and providers are supported with the necessary resources and expertise to better assist their patients in managing their illness. Traditionally, the doctor’s role has been to diagnose and prescribe, while the patient’s role was to be compliant with the doctor’s orders. While this approach may still be very effective when dealing with an acute ailment, an effective approach to a chronic disease requires a partnership between you and your healthcare providers.Self-management is a term used to describe the decisions and actions an individual takes to cope with or improve their health. It includes managing aspects of their condition, such as pain, fatigue and medication, and using health promotion strategies such as diet, exercise and stress reduction. A chronic disease self-management program helps people develop the skills necessary to maintain or improve their own well being, gain greater independence, and increase confidence in dealing with the physical and emotional challenges of a long-term illness.Chronic disease self-management programs are currently looking beyond the usual patient education about an illness to examining how a chronic disease affects a person’s daily life and their quality of life. It is a complementary support system that utilizes trained volunteers to help participants get new information, learn new skills and abilities, and develop new ways to manage and cope with chronic conditions. Some of the components of a good self-management program include:
- developing a suitable exercise program
- cognitive symptom management
- nutrition management
- breathing exercises
- problem solving
- use of medication
- communicating with family, friends and healthcare providers
- dealing with emotions such as anger and depression.